Deliberate self-harm patients who leave the accident and emergency department without a psychiatric assessment

2001 ◽  
Vol 50 (2) ◽  
pp. 87-93 ◽  
Author(s):  
Lilian Hickey ◽  
Keith Hawton ◽  
Joan Fagg ◽  
Heather Weitzel
Keyword(s):  
Emergency Department ◽  
Psychiatric Assessment ◽  
Deliberate Self Harm ◽  
Accident And Emergency ◽  
Self Harm ◽  
Accident And Emergency Department

scholarly journals Deliberate self-harm and antidepressant drugs

2000 ◽  
Vol 177 (6) ◽  
pp. 551-556 ◽  
Author(s):  
Stuart Donovan ◽  
Andrew Clayton ◽  
Min Beeharry ◽  
Sheron Jones ◽  
Chris Kirk ◽  
...  
Keyword(s):  
Emergency Department ◽  
Prospective Study ◽  
Serotonin Reuptake ◽  
Antidepressant Drugs ◽  
Tricyclic Antidepressant ◽  
Deliberate Self Harm ◽  
Accident And Emergency ◽  
Self Harm ◽  
Accident And Emergency Department ◽  
A Prospective Study

BackgroundIt is not clear if the frequency of deliberate self-harm (DSH) is the same in patients taking different pharmacological classes of antidepressant drugs.AimsTo compare the frequency of DSH in patients who had been prescribed a tricyclic antidepressant (TCA) or a selective serotonin reuptake inhibitor (SSRI) prior to the DSH event.MethodThis was a prospective study in 2776 consecutive DSH cases attending an accident and emergency department. The incidence of DSH in TCA-treated cases and SSRI-treated cases is expressed as number of DSH events per 10 000 prescriptions of each antidepressant.ResultsSignificantly more DSH events occurred following the prescription of an SSRI than that of a TCA (P < 0.001). The occurrence of DSH was highest with fluoxetine and lowest with amitriptyline.ConclusionsMerely prescribing safer-in-overdose antidepressants is unlikely to reduce the overall morbidity from DSH.

scholarly journals Attendance at the accident and emergency department in the year before suicide: Retrospective study

2003 ◽  
Vol 183 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Isaura Gairin ◽  
Allan House ◽  
David Owens
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Mental Health Service ◽  
Health Service ◽  
Health Services ◽  
Emergency Departments ◽  
Accident And Emergency ◽  
Self Harm ◽  
Accident And Emergency Department ◽  
Service Contact

BackgroundThe National Confidential Inquiry into suicides in England and Wales found that a quarter of suicides are preceded by mental health service contact in the year before death. However, visits to accident and emergency departments due to self-harm may not lead to a record of mental health service contact.AimsTo determine the proportion of suicides preceded by accident and emergency attendance in the previous year.MethodWe obtained the list of probable suicides in Leeds for a 38-month period, and examined the records from thecity's accident and emergency departments for a year before each death.ResultsEighty-five (39%) of the 219 people who later died by suicide had attended an accident and emergency department in the year before death, 15% because of non-fatal self-harm. Final visits dueto self-harm were often shortly before suicide (median 38 days), but the National Confidential Inquiry recorded about a fifth of them as‘not in contact’ with local mental health services.ConclusionsAlthough many suicides are preceded by recent attendance at accident and emergency departments due to non-fatal self-harm, local mental health service records may show no recent contact. Suicide prevention might be enhanced were accident and emergency departments and mental health services to work together more closely.

scholarly journals Increasing psychosocial assessment by introducing a self-harm pathway

2006 ◽  
Vol 30 (5) ◽  
pp. 169-172 ◽  
Author(s):  
Peter Lepping ◽  
Barbara Woodworth ◽  
Lucy Roberts ◽  
Jim Turner
Keyword(s):  
Emergency Department ◽  
The Self ◽  
Psychosocial Assessment ◽  
Clinical Implications ◽  
Protocol Adherence ◽  
Steering Group ◽  
Accident And Emergency ◽  
Before And After ◽  
Self Harm ◽  
Accident And Emergency Department

Aims and MethodTo audit whether the introduction of a self-harm pathway and protocol increases the number of psychosocial assessments. All episodes of self-harm in a defined period during 2002 (n=335) and 2004 (n=390) were reviewed before and after the introduction of a self-harm pathway and protocol. Adherence to the protocol was also investigated.ResultsAfter the introduction of the self-harm pathway and protocol, the proportion of psychosocial assessments requested had risen from 57% (2002) to 85% (2004). The proportion of psychosocial assessments completed had risen from 47% to 70%. Over the 2 years, the overall number of self-harm presentations was reduced by 27%.Clinical ImplicationsThe introduction of a self-harm pathway and protocol through a self-harm steering group is feasible, was well accepted and increased the number of psychosocial assessments after self-harm. It may also contribute to a reduction in the number of overall presentations with self-harm to the accident and emergency department.

scholarly journals Deliberate Self-Harm: Clinical and Socio-Economic Characteristics of 368 Patients

1975 ◽  
Vol 127 (6) ◽  
pp. 564-574 ◽  
Author(s):  
H. Gethin Morgan ◽  
Christopher J. Burns-Cox ◽  
Helen Pocock ◽  
Susan Pottle
Keyword(s):  
Antisocial Behaviour ◽  
Alcohol Addiction ◽  
Royal Infirmary ◽  
Age Group ◽  
Deliberate Self Harm ◽  
Functional Psychosis ◽  
Accident And Emergency ◽  
Self Harm ◽  
Accident And Emergency Department ◽  
Previous Occasion

SummaryIn this study 368 patients were interviewed after they had attended the Bristol Royal Infirmary Accident and Emergency Department following a non-fatal act of deliberate self-harm. There were twice as many women (247) as men (121), and two thirds of the patients were in the 15–35 age group. Ninety-five per cent had taken a drug overdose, most commonly one or more of the tranquillizers, antidepressants, hypnotics or analgesics. Seventy-eight per cent had taken drugs prescribed by a doctor. Half the patients mentioned interpersonal conflict as a major precipitating factor in the episode. A psychiatric diagnosis was completed for all admitted patients, of whom 52 per cent were considered to be suffering from neurotic depression, 29 per cent from personality disorder, 12 per cent from functional psychosis and 10 per cent from alcohol addiction. Almost half had deliberately harmed themselves on a previous occasion. The series showed a greater than average incidence of unemployment, overcrowded living conditions, divorce and antisocial behaviour. The implications of these findings for the clinical management and prevention of non-fatal deliberate self-harm are discussed.

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